Peyronies Disease Treatment Options
Because Peyronies Disease, sometimes called Induratio Penis Plastica (IPP), is yet to be adequately understood, it is not surprising that there is no cure and no universally agreed upon best treatment. There is also very little standardization of treatments, including those treatments listed in the "Traditional Treatment" category. Treatment results are often difficult to compare due to lack of controlled objective clinical studies. Results are further confused because an estimated 5% to 15% pf Peyronies Disease patients experience a spontaneous resolution of the disease without treatment. In cases of improvement, this always leaves a question of whether it was the treatment or simply a case of spontaneous resolution.
In addition to the particular treatment preferences of disagreeing parties, there are many other issues that effect an informed decision about which treatment(s) to pursue.
Considerations in Choosing treatment:
Characteristics of your individual case: What are your individual symptoms? Is there bend, curvature, wasting, pain, erectile dysfunction? To what degree are these present?
Stage: Peyronies Disease is divided into two stages; acute and chronic. While some try to determine the stage according to a time table, even a brief exchange with a wide number of patients will make it clear that once again, every case is individual. During the initial "acute stage" there is inflammation with possible pain and maybe some deformity. This stage is said to last from 8 to 18 months. Again, conversation with a range of real patients reveals that Peyronies Disease may have acute stage flare-ups periodically over decades. Since much is changing during this stage, the goal is to reduce the inflammation, reduce the likelihood of damage and deformity, and hope for some spontaneous reversal of the condition. It is the the opinion of most doctors with practical experience treating Peyronies Disease, that this is an important period in which the long term outcome can be effected. It should not be wasted buy just waiting.
The acute stage is followed by the chronic stage in which the the disease often stabilizes for some period of time. Pain usually resolves, erectile dysfunction my become more severe, and there may be calcification of the plaque. Surgical treatment is always reserved for those that reach the acute stage with very significant symptoms which make intercourse impossible or highly problematic.
Availability: The availability of many treatments is localized to a few centers on a given continent. Even many of the more traditional treatments require a urologist with a interest and training in Peyronies Disease. Currently, doctors with this background are not found in most urology practices.
Cost: Cost can be a factor, since many of these treatments are very expensive and many are not covered by insurance benefits.
Risk: Risk of treatment is as varied as the treatments themselves. These risks should be clearly understood before proceeding. Here the patient shares in the responsibility to research the issues objectively and not hear just what they want to hear. Having frank conversations with your doctor and entering into discussions with other patients is critical during this process.
We will proceed with a brief discussion of these treatments by dividing them into 3 major categories. These categories are loosely defined. Treatments often overlap into more than one category, or change from one category to another.
These divisions are: